Optimal adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma

A radiotherapy perspective

Kyung Hwan Kim, Jee Suk Chang, Ji Hye Cha, Ik Jae Lee, Dae Joon Kim, ByoungChul Cho, Kyung Ran Park, Chang Geol Lee

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose The purpose of this study was to evaluate the benefits of adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma (ESCC) and determine the optimal adjuvant treatments. Materials and Methods One hundred ninety-five patients who underwent a curative resection for thoracic ESCC between 1994 and 2014 were reviewed retrospectively. Postoperatively, the patients received no adjuvant treatment (no-adjuvant group, n=68), adjuvant chemotherapy (AC group, n=62), radiotherapy (RT group, n=41), or chemoradiotherapy (CRT group, n=24). Chemotherapy comprised cisplatin and 5-fluorouracil administration every 3 weeks. The median RT dose was 45.0 Gy (range, 34.8 to 59.4 Gy). The overall survival (OS), diseasefree survival (DFS), locoregional recurrence (LRR), and distant metastasis (DM) rates were estimated. Results At a median follow-up duration of 42.2 months (range, 6.3 to 215.2 months), the 5-year OS and DFS were 37.6% and 31.4%, respectively. After adjusting for other clinicopathologic variables, the AC and CRT groups had a significantly better OS and DFS compared to the no-adjuvant group (p < 0.05). The LRR rate was significantly lower in the RT and CRT groups than in the no-adjuvant group (p < 0.05), whereas no significant difference was observed in the AC group. In the no-adjuvant and AC groups, 25% of patients received high-dose salvage RT due to LRR. The DM rates were similar. The anastomotic stenosis and leakage were similar in the treatment groups. Conclusion Adjuvant treatment might prolong survival after an ESCC resection, and RT contributes to a reduction of the LRR. Overall, the risks and benefits should be weighed properly when selecting the optimal adjuvant treatment.

Original languageEnglish
Pages (from-to)168-177
Number of pages10
JournalCancer Research and Treatment
Volume49
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Radiotherapy
Thorax
Survival
Recurrence
Therapeutics
Neoplasm Metastasis
Anastomotic Leak
Chemoradiotherapy
Adjuvant Chemotherapy
Esophageal Squamous Cell Carcinoma
Fluorouracil
Cisplatin
Pathologic Constriction
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Kim, Kyung Hwan ; Chang, Jee Suk ; Cha, Ji Hye ; Lee, Ik Jae ; Kim, Dae Joon ; Cho, ByoungChul ; Park, Kyung Ran ; Lee, Chang Geol. / Optimal adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma : A radiotherapy perspective. In: Cancer Research and Treatment. 2017 ; Vol. 49, No. 1. pp. 168-177.
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title = "Optimal adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma: A radiotherapy perspective",
abstract = "Purpose The purpose of this study was to evaluate the benefits of adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma (ESCC) and determine the optimal adjuvant treatments. Materials and Methods One hundred ninety-five patients who underwent a curative resection for thoracic ESCC between 1994 and 2014 were reviewed retrospectively. Postoperatively, the patients received no adjuvant treatment (no-adjuvant group, n=68), adjuvant chemotherapy (AC group, n=62), radiotherapy (RT group, n=41), or chemoradiotherapy (CRT group, n=24). Chemotherapy comprised cisplatin and 5-fluorouracil administration every 3 weeks. The median RT dose was 45.0 Gy (range, 34.8 to 59.4 Gy). The overall survival (OS), diseasefree survival (DFS), locoregional recurrence (LRR), and distant metastasis (DM) rates were estimated. Results At a median follow-up duration of 42.2 months (range, 6.3 to 215.2 months), the 5-year OS and DFS were 37.6{\%} and 31.4{\%}, respectively. After adjusting for other clinicopathologic variables, the AC and CRT groups had a significantly better OS and DFS compared to the no-adjuvant group (p < 0.05). The LRR rate was significantly lower in the RT and CRT groups than in the no-adjuvant group (p < 0.05), whereas no significant difference was observed in the AC group. In the no-adjuvant and AC groups, 25{\%} of patients received high-dose salvage RT due to LRR. The DM rates were similar. The anastomotic stenosis and leakage were similar in the treatment groups. Conclusion Adjuvant treatment might prolong survival after an ESCC resection, and RT contributes to a reduction of the LRR. Overall, the risks and benefits should be weighed properly when selecting the optimal adjuvant treatment.",
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Optimal adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma : A radiotherapy perspective. / Kim, Kyung Hwan; Chang, Jee Suk; Cha, Ji Hye; Lee, Ik Jae; Kim, Dae Joon; Cho, ByoungChul; Park, Kyung Ran; Lee, Chang Geol.

In: Cancer Research and Treatment, Vol. 49, No. 1, 01.01.2017, p. 168-177.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Optimal adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma

T2 - A radiotherapy perspective

AU - Kim, Kyung Hwan

AU - Chang, Jee Suk

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AU - Lee, Chang Geol

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N2 - Purpose The purpose of this study was to evaluate the benefits of adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma (ESCC) and determine the optimal adjuvant treatments. Materials and Methods One hundred ninety-five patients who underwent a curative resection for thoracic ESCC between 1994 and 2014 were reviewed retrospectively. Postoperatively, the patients received no adjuvant treatment (no-adjuvant group, n=68), adjuvant chemotherapy (AC group, n=62), radiotherapy (RT group, n=41), or chemoradiotherapy (CRT group, n=24). Chemotherapy comprised cisplatin and 5-fluorouracil administration every 3 weeks. The median RT dose was 45.0 Gy (range, 34.8 to 59.4 Gy). The overall survival (OS), diseasefree survival (DFS), locoregional recurrence (LRR), and distant metastasis (DM) rates were estimated. Results At a median follow-up duration of 42.2 months (range, 6.3 to 215.2 months), the 5-year OS and DFS were 37.6% and 31.4%, respectively. After adjusting for other clinicopathologic variables, the AC and CRT groups had a significantly better OS and DFS compared to the no-adjuvant group (p < 0.05). The LRR rate was significantly lower in the RT and CRT groups than in the no-adjuvant group (p < 0.05), whereas no significant difference was observed in the AC group. In the no-adjuvant and AC groups, 25% of patients received high-dose salvage RT due to LRR. The DM rates were similar. The anastomotic stenosis and leakage were similar in the treatment groups. Conclusion Adjuvant treatment might prolong survival after an ESCC resection, and RT contributes to a reduction of the LRR. Overall, the risks and benefits should be weighed properly when selecting the optimal adjuvant treatment.

AB - Purpose The purpose of this study was to evaluate the benefits of adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma (ESCC) and determine the optimal adjuvant treatments. Materials and Methods One hundred ninety-five patients who underwent a curative resection for thoracic ESCC between 1994 and 2014 were reviewed retrospectively. Postoperatively, the patients received no adjuvant treatment (no-adjuvant group, n=68), adjuvant chemotherapy (AC group, n=62), radiotherapy (RT group, n=41), or chemoradiotherapy (CRT group, n=24). Chemotherapy comprised cisplatin and 5-fluorouracil administration every 3 weeks. The median RT dose was 45.0 Gy (range, 34.8 to 59.4 Gy). The overall survival (OS), diseasefree survival (DFS), locoregional recurrence (LRR), and distant metastasis (DM) rates were estimated. Results At a median follow-up duration of 42.2 months (range, 6.3 to 215.2 months), the 5-year OS and DFS were 37.6% and 31.4%, respectively. After adjusting for other clinicopathologic variables, the AC and CRT groups had a significantly better OS and DFS compared to the no-adjuvant group (p < 0.05). The LRR rate was significantly lower in the RT and CRT groups than in the no-adjuvant group (p < 0.05), whereas no significant difference was observed in the AC group. In the no-adjuvant and AC groups, 25% of patients received high-dose salvage RT due to LRR. The DM rates were similar. The anastomotic stenosis and leakage were similar in the treatment groups. Conclusion Adjuvant treatment might prolong survival after an ESCC resection, and RT contributes to a reduction of the LRR. Overall, the risks and benefits should be weighed properly when selecting the optimal adjuvant treatment.

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